Hemorrhagic stroke accounts for about 13 percent of stroke cases. Hemorrhagic strokes result from a weakened vessel that ruptures and bleeds into the surrounding brain. The blood accumulates and compresses the surrounding brain tissue. The two types of hemorrhagic strokes are intracerebral (within the brain) hemorrhage or subarachnoid hemorrhage.

- An aneurysm is a ballooning of a weakened region of a blood vessel. If left untreated, the aneurysm continues to weaken until it ruptures and bleeds into the brain.

- An arteriovenous malformation (AVM) is a cluster of abnormally formed blood vessels. Any one of these vessels can rupture, also causing bleeding into the brain.

Symptoms of a hemorrhagic stroke

A hemorrhagic stroke that occurs inside your brain is also called an intracerebral hemorrhage. Symptoms of an ICH can vary from person to person, but are almost always present immediately after the stroke occurs.

Symptoms may include:

- total or limited loss of consciousness - nausea - vomiting - sudden and severe headache - weakness or numb feeling in the face, leg, or arm on one side of the body - seizures - dizziness - loss of balance - problems with speech or swallowing - confusion or disorientation

A stroke is a medical emergency. Call emergency medical services or have someone drive you to the hospital if you think you’re having a stroke.

Causes of a hemorrhagic stroke

There are two possible causes of a ruptured blood vessel in the brain. The most common cause is an aneurysm. An aneurysm occurs when a section of a blood vessel becomes enlarged from chronic and dangerously high blood pressure or when a blood vessel wall is weak, which is usually congenital. This ballooning leads to thinning of the vessel wall, and ultimately to a rupture.

A rarer cause of an ICH is an arteriovenous malformation (AVM). This occurs when arteries and veins are connected abnormally without capillaries between them. AVMs are congenital. This means they are present at birth, but they are not hereditary. It is unknown exactly why they occur in some people.

Emergency treatment for a hemorrhagic stroke

Immediate emergency care is crucial for a hemorrhagic stroke. This treatment focuses on controlling the bleeding in your brain and reducing the pressure caused by the bleeding.Drugs can be used to reduce blood pressure or to slow down the bleeding. If you experience a hemorrhagic stroke while on blood thinners, you are at particular risk for excessive bleeding. Drugs to counteract the effect of the blood thinners are usually given right away during emergency treatment.

Surgical Treatment

Once a hemorrhagic stroke is brought under control with emergency care, further treatment measures can be taken. If the rupture is small and produces only a small amount of bleeding and pressure, supportive care may be the only other form of care you need. This may include:

For more serious strokes, surgery may be needed to repair the ruptured blood vessel and stop the bleeding. If the stroke is caused by an AVM, surgery may be used to remove it. This is not always possible, however, and depends on the location of the AVM. Surgery may also be required to relieve the pressure caused by the bleeding and brain swelling.